<div class="row">
    <div class="col-xs-12">
        <div class="panel panel-midnightblue">
            <div class="panel-body">
                <form action="" class="form-horizontal row-border"  data-validate="parsley" id="validate-form">
                	<div class="row">
                		 <div class="form-group">
                    		<label class="col-sm-3 control-label" >绑定卡号:</label>
                    		<div class="col-sm-5">
                    			<input type="text"  value="{$model.card_no}" readonly  required="required"  name="card_no" class="form-control" id="card_no"/>
                    		</div>
                    		<div class="col-sm-1">
                    			 <div class="btn-danger btn" id="btn-sync">同步</div>
                    		</div>
                    		<div class="col-sm-1">
                    			 <div class="btn-primary btn" id="form-submit">提交</div>
                    		</div>
                    		<div class="col-sm-1">
                    			 <div class="btn-default btn" data-dismiss="modal">关闭</div>
                    		</div>
                   		 </div>
                	</div>
                    
                    <div class="form-group col-sm-6">
                    		<label class="col-sm-3 control-label" >会员姓名:</label>
                    		<div class="col-sm-6">
                    			<input type="text" id="name"  name="name" value="{$model.name}" readonly class="form-control">
                    		</div>
                    	</div>
                    <div class="form-group col-sm-6">
                    		<label class="col-sm-3 control-label" >会员手机号:</label>
                    		<div class="col-sm-6">
                    			<input type="text" id="mobile"  name="mobile" value="{$model.mobile}"  class="form-control">
                    		</div>
                    </div>	
                    <div class="form-group col-sm-6">
                    		<label class="col-sm-3 control-label">会员合同号:</label>
                    		<div class="col-sm-6">
                    			<input type="text" id="contract_id"   value="{$model.contract_id}"  name="contract_id" readonly class="form-control">
                    		</div>
                    </div>
                    <div class="form-group col-sm-6">
                    		<label class="col-sm-3 control-label" >会员标识符:</label>
                    		<div class="col-sm-6">
                    			<input type="text" value="{$model.member_id}"  id="member_id" name="member_id" readonly  class="form-control">
                    		</div>
                    </div>
                     <div class="form-group col-sm-6">
                    		<label class="col-sm-3 control-label" >有效期开始:</label>
                    		<div class="col-sm-6">
                    			<input type="text"   id="start_date" name="start_date" value="{$model.start_date}" readonly  class="form-control">
                    		</div>
                    </div>
                    <div class="form-group col-sm-6">
                    		<label class="col-sm-3 control-label" >有效期结束:</label>
                    		<div class="col-sm-6">
                    			<input type="text"   id="end_date" value="{$model.end_date}"  name="end_date" readonly  class="form-control">
                    		</div>
                    </div>
                    <div class="form-group col-sm-6">
                    		<label class="col-sm-3 control-label" >剩余次数:</label>
                    		<div class="col-sm-6">
                    			<input type="text"   id="surplus_num" value="{$model.surplus_num}" name="surplus_num" readonly  class="form-control">
                    		</div>
                    </div>
                    <div class="form-group col-sm-6">
                    		<label class="col-sm-3 control-label" >会员类型:</label>
                    		<div class="col-sm-6">
                    			<input type="text"   id="membership_type" value="{$model.membership_type}" name="membership_type" readonly  class="form-control">
                    		</div>
                    </div>
                    <div class="form-group col-sm-6">
                    		<label class="col-sm-3 control-label" >合同状态:</label>
                    		<div class="col-sm-6">
                    			<input type="text"   id="contract_status" readonly value="{$model.contract_status}" name="contract_status"   class="form-control">
                    		</div>
                    </div>
                    <input type="hidden" id="id" value="{$model.id}" name="id"/>
                </form>
            </div>
            <div class="panel-footer">
                <div class="row">
                    <div class="col-sm-6 col-sm-offset-3">
                        <div class="btn-toolbar">
                            
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>
<script type='text/javascript' src='{$Think.ADMIN_VIEW_JS}member/sync.js'></script>